Treatment of tension-type headache

Vaiva Kaktaitė1, Marija Hibner1, Vitalija Dapšauskaitė2, Miglius Mikalauskas3

1Lithuanian University of Health Sciences, Medicine academy, Kaunas, Lithuania

2Vilnius University Hospital Santaros Clinics, Neurology department, Vilnius, Lithuania

3Lithuanian University of Health Sciences Kaunas Clinics, Radiology department, Kaunas, Lithuania


Background. Tension-type headache (TTH) is one of the most common primary headache disorders, affecting approximately 26-38 % of the global population. It is a mild to moderate headache lasting from a few minutes to several weeks. It can be episodic or chronic. Pharmacological and non-pharmacological options are prescribed for the treatment and prevention of TTH.

Aim: to review the latest scientific literature of pharmacological and non-pharmacological treatment recommendations for tension-type headache.

Methods. Scientific literature research was performed using PubMed, ClinicalKey and Google Scholar databases. The search was performed according to the keywords: tension-type headache, pharmacological treatment, nonpharmacological treatment. Articles from 2020 to 2023 were selected. Inclusion criteria: full-text articles in English, prospective and retrospective studies, meta-analyses, literature analyses, clinical trials. Exclusion criteria: scientific articles are not written in English, clinical cases. After applying the selection criteria, 16 publications were selected for the analysis.

Results. Pharmacological medications for the treatment of acute tension-type headache are analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) Together with pain management, it is recommended to prescribe long-term treatment with antidepressants as acute pain prevention. The most effective non-pharmacological methods of tension-type headache treatment are physiotherapy – manual therapy, bio-feedback electromyography. Non-pharmacological treatment methods, such as physical exercises, acupuncture, can be both treatment and
prevention options for pain management.

Conclusions. The main evidence-based effective recommended medications are analgesics, non-steroidal antiinflammatory drugs and tricyclic antidepressants. Treatment should include the most effective nonpharmacological treatment methods, such as manual therapy, bio-feedback electromyography, acupuncture.

Keywords: tension-type headache, pharmacological treatment, non-pharmacological treatment.

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